Kaitlyn M Pozorski, LCSW
Individual provider Active NPI Clinical Social Worker · Fort Wayne, IN
NPI 1700469657 · NPPES record last updated Apr 29, 2021
Key facts
- NPI
- 1700469657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 34009185A (IN)
- Practice address
- 2712 S Calhoun St
Fort Wayne, IN 46807-1402 - Phone
- (260) 744-4326
- Fax
- (260) 744-0188
- NPI assigned
- Apr 29, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alliance Health Centers Inc
Practice addresses (Care Compare)
2700 Lafayette St
Suite 110
Fort Wayne, IN 46806-1100
Phone (260) 266-0780
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210526001353 | IN | Practitioner - Clinical Social Worker | 9032518949 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34009185A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay Mental Health LLC | Clinical | Current |
Accepting new patients |
| Alliance Health Centers, Inc. | Current |
Accepting new patients | |
| Alliance Health Centers Inc. | Current |
Accepting new patients |
Locations
2700 Lafayette St
Ste 110
Fort Wayne, IN 46806
Phone (260) 660-0780
10331 Dawsons Creek Blvd
Ste D
Fort Wayne, IN 46825
Phone (260) 489-8646
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34009185A | IN | Yes |
Addresses
Primary practice location
2712 S Calhoun St
Fort Wayne, IN 46807-1402
Mailing address
2712 S Calhoun St
Fort Wayne, IN 46807-1402
Phone (260) 744-4326
Other names
- Kaitlyn M Syzmanski
NPI Registry JSON
{
"created_epoch": "1619654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1700469657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2712 S CALHOUN ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468071402",
"telephone_number": "260-744-4326",
"fax_number": "260-744-0188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2712 S CALHOUN ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468071402",
"telephone_number": "260-744-4326",
"fax_number": "260-744-0188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POZORSKI",
"first_name": "KAITLYN",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-29",
"last_updated": "2021-04-29",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34009185A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KAITLYN",
"last_name": "SYZMANSKI",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Wayne, IN
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- Abigail Dormire Powers
- Elise Powers
- Janice M Powers
- Charisse L Prall
- Amber Jolie Nicole Pranger
- Christina Pranger
- Joshua Pranger
- Apurwa Prasad
All providers in Fort Wayne, IN · Clinical Social Worker in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.